Advances in prophylaxis and treatment of recurrent hepatitis B after liver transplantation
Zi-Fa Wang, Zhi-Jun Zhu and Zhong-Yang Shen
Tianjin, China
Author Affiliations: Oriental Organ Transplantation Center, Tianjin First Central Hospital, Tianjin 300191, China (Wang ZF, Zhu ZJ and Shen ZY) Corresponding Author: Zi-Fa Wang, MD, Oriental Organ Transplantation Center, Tianjin First Central Hospital, Tianjin 300191, China (Tel: 86-22-23626611; Fax: 86-22-23682662;Email: wangzf15213@yahoo.com)
BACKGROUND: In the 1990s, liver transplantation for hepatitis B virus (HBV) related-liver diseases was a very controversial issue because the graft was inevitably recurrent after liver transplantation. Significant progress has been made in the prophylaxis and treatment of recurrent hepatitis B after liver transplantation. This review covers the mechanisms, prophylaxis, and treatment of hepatitis B recurrent after liver transplantation. DATA SOURCES: Searching MEDLINE (1995-2004) for articles on liver transplantation.
RESULTS: HBV reinfection after liver transplantation results from HBV particles in circulation or other extrahepatic sites. Hepatitis B immune globulin (HBIG) was effective in reducing HBV reinfection and improving graft survival after liver transplantation. Lamivudine has also dramatically reduced the recurrence of HBV in the patient undergoing liver transplantation.
CONCLUSIONS: Combination HBIG and lamivudine is the most effective porphylatic regimen. Lamivudine and adefovir are highly effective in treatment of HBV recurrence. HBV-related liver disease is no longer a contraindication for liver transplantation.
2005, Vol. 4 
